"Not so FAST" - Dr. Bialeck

  • 24 YO M MVC with normal vitals, no ab ttp, + Humerus FX

  • First "quick glance" of the FAST ....

  • Free Fluid or no free fluid?

  • Where do we look for free fluid in the RUQ?

  • Is there a “distracting” injury?

  • FAST doesn’t mean go FAST… Slow down, especially in the bladder view where subtle free fluid can be missed.

  • The FIRST place where fluid may accumulate in the RUQ is the inferior pole of the right kidney/liver tip.

  • Isolated view of Morrison’s pouch may not be sufficient!

  • “Distracting Injury” can be subjective.